Social Media in Urology Practice

Department of Urology

Case of the Month

Social Media in Urology Practice

CASE PRESENTATION

This month¡¯s case presentation includes two side-by-side scenarios illustrating the potential

impacts of social media, both positive and negative, for patients with urological conditions and

for practicing urologists.

CASE 1:

The hypothetical patient is a 65yo male who presents to the clinic to discuss the management

of clinically localized prostate cancer. He reports that he went on YouTube where he saw a

video promoting herbal injections into the prostate as a miracle cure with no side effects. This

was appealing because he heard that conventional treatments are associated with a risk of

erectile dysfunction and sexual function is a priority. He is wondering if these treatments are

available locally or if he should pay cash for the treatment internationally.

COMMENT

The majority of U.S. adults look online for health information.1 Correspondingly, the spread of

misinformation through social networks is a major public health issue, which has received

increasing attention during the COVID19 pandemic.2

Our group and others have reported extensively on the spread of misinformation about

urological health conditions on social media. In a study of the first 150 videos in a search about

¡°prostate cancer¡± on YouTube, 21% contained a substantial amount of misinformation.3 Videos

with the lowest quality had significantly more views over time.

Similar findings have been reported on other social networks and about other urological

issues.4 For example, a recent review article of the quality of information on YouTube about

men¡¯s health issues, including hypogonadism, Peyronie¡¯s disease, and erectile dysfunction,

found that most videos were unreliable.5 Further, inaccurate videos either received similar or

greater engagement from viewers (e.g., views, likes), raising concern about exposure to

misinformation by lay health consumers.

What else can we do as urologists in the fight against misinformation? An important tip is to be

prescriptive about patient education materials. This could involve handing out flyers and/or

sharing a list of recommended resources, such as the Urology Care Foundation and other

trusted sources. An additional option is to create your own resources for patient education.

Many urologists are creating new evidence-based content, whether through social media or

other platforms such as podcasts or blogs. Factors that can guide the selection of a platform

include what type of medium is most comfortable for you and the type of condition and target

audience. YouTube has the largest overall user base in the United States, followed by Facebook.6

Other platforms such as Instagram and TikTok may be useful for reaching younger audiences.

Finally, Twitter is very useful for inter-professional discussions, as we will discuss in the next case.

CASE OF THE MONTH

CASE 2:

A urologist has just seen a patient with kidney stones and complex anatomy. The urologist obtains

consent from the patient and posts the patient¡¯s images to Twitter to ask other urologists for their

feedback about the case. Many colleagues from around the world share their perspectives, ultimately

leading to a change in the surgical approach, which was used to treat the patient successfully.

COMMENT

Social media offers unique new opportunities for clinical crowdsourcing and scientific exchange

among healthcare professionals.7,8 For example, in a survey of urologists using Twitter, the vast

majority found it useful for networking, disseminating information, research, advocacy and

career development.9

Clinical case discussions can be conducted through social media, which may have a direct impact

on patient care.8, 10 Additionally, surgical videos posted to social media are widely used by urology

trainees as a learning tool.11

Social media is a great way for urologists to advertise their practice, and social networks rank

highly in search engines. For urology training programs, social media has taken on a new

prominence during the pandemic with the transition of away rotations and interviews to a virtual

format. Activity on Twitter has a significant positive association with reputation scores in the

U.S. News and World Report rankings.12

From a research standpoint, social media may be used to recruit participants and as a source of

data. Social networks are also extremely valuable for research dissemination. Greater social media

activity surrounding scientific publications is associated with an increased number of citations.13

With respect to education and knowledge exchange, Twitter has been successfully used as a

forum to conduct international journal clubs about urological topics.14-16 Social media have also

been used for broad dissemination of clinical practice guidelines.17

However, with these benefits also comes several risks including the potential for breaches of

patient confidentiality and disciplinary action. For example, when sharing images on social media,

it is important to remove any patient identifiers that may be present. Other recommendations are

avoiding mention of timing that could link the discussion to a specific patient and checking your

institutional policy on social media.

Several groups have published recommendations for optimal social media use in the field of

urology, which were recently reviewed.18 Many of these recommendations are analogous to offline

professional standards, including protection of patient privacy and avoiding public disclosure of

protected health information.

Unfortunately, despite the widespread use of social networks in the urological community, most

urologists and trainees are not familiar with professional guidelines on social media use.19,20

Other possible harms resulting from social media use include the potential for online harassment

and loss of productivity, psychological or physical consequences from excessive use. For

example, we found that 6% of practicing urologists and 11% of urology trainees met the criteria

for Social Media Disorder using a validated instrument designed to differentiate unhealthy social

media use.19,20 Overall, the topic of social media use must be integrated into urology training and

continuing medical education to optimally reap the potential benefits of these massive platforms

for public education and scientific exchange, while minimizing associated risks.

CASE OF THE MONTH

REFERENCES

1. Pew Internet & American Life Project Health Online 2013. files/old-media/Files/Reports/PIP_HealthOnline.pdf.

Accessed September 23, 2017.

2. Lee JJ, Kang KA, Wang MP, Zhao SZ, Wong JYH, O¡¯Connor S, et al. Associations between COVID-19 misinformation exposure and belief

with COVID-19 knowledge and preventive behaviors: Cross-sectional online study. Journal of Medical Internet Research. 2020;22:e22205.

3. Loeb S, Sengupta S, Butaney M, Macaluso JN, Jr., Czarniecki SW, Robbins R, et al. Dissemination of misinformative and biased

Information about prostate cancer on YouTube. European Urology. 2019;75:564-7.

4. Xu AJ, Taylor J, Gao T, Mihalcea R, Perez-Rosas V, Loeb S. TikTok and prostate cancer: misinformation and quality of information using

validated questionnaires. BJU International. 2021. doi: 10.1111/bju.15403.

5. Warren CJ, Sawhney R, Shah T, Behbahani S, Sadeghi-Nejad H. YouTube and men¡¯s health: A review of the current literature. Sexual

Medicine Reviews. 2021;9:280-8.

6. Pew Research Center Social Media Fact Sheet. fact-sheet/social-media/. Accessed July 17, 2021.

7. Loeb S, Catto J, Kutikov A. Social media offers unprecedented opportunities for vibrant exchange of professional ideas across

continents. European Urology. 2014;66:118-9.

8. Sternberg KM, Loeb SL, Canes D, Donnelly L, Tsai MH. The use of Twitter to facilitate sharing of clinical expertise in urology. Journal of

the American Medical Informatics Association. 2018;25:183-6.

9. Borgmann H, DeWitt S, Tsaur I, Haferkamp A, Loeb S. Novel survey disseminated through Twitter supports its utility for networking,

disseminating research, advocacy, clinical practice and other professional goals. Canadian Urological Association Journal. 2015;9:E713-7.

10. Gudaru K, Blanco, LT, Castellani, D, Santamaria, HT, Pelayo-Nieto, M., Linden-Castro, E, Wroclawski, M ., Bellote, MC, Inarritu, JM, Da

Silva, RD, Gauhar, V, Adwin, Z, & Teoh, JY-C. Connecting the urological community: The #UroSoMe Experience. Journal of Endoluminal

Endourology. 2019;2:e20-e9.

11. Rivas JG, Socarras MR, Patruno G, Uvin P, Esperto F, Dinis PJ, et al. Perceived role of social media in urologic knowledge acquisition

among young urologists: A European survey. European Urology Focus. 2018;4:768-73.

12. Ciprut S, Curnyn C, Davuluri M, Sternberg K, Loeb S. Twitter activity associated with U.S. News and World Report reputation scores

for urology departments. Urology. 2017;108:11-6.

13. Hayon S, Tripathi H, Stormont IM, Dunne MM, Naslund MJ, Siddiqui MM. Twitter mentions and academic citations in the urologic

literature. Urology. 2019;123:28-33.

14. Bayne CE, Cardona-Grau D, Hsieh MH. Introducing the pediatric urology journal club on Twitter. Journal of Pediatric Urology. 2017;13:2-3.

15. Thangasamy IA, Loeb S, Sathianathen NJ, Leveridge M, Stork B, Davies BJ, et al. Evaluating the effectiveness of an online journal club:

Experience from the international urology journal club. European Urology Focus. 2021;7:482-8.

16. Loeb S, Taylor J, Butaney M, Byrne NK, Gao L, Soule HR, et al. Twitter-based prostate cancer journal club (#ProstateJC) promotes

multidisciplinary global scientific discussion and research dissemination. European Urology. 2019;75:881-2.

17. Bhatt NR, Czarniecki SW, Borgmann H, van Oort IM, Esperto F, Pradere B, et al. A systematic review of the use of social media for

dissemination of clinical practice guidelines. European Urology Focus. 2020.

18. Taylor J, Loeb S. Guideline of guidelines: social media in urology. BJU international. 2020;125:379-82.

19. Dubin JM, Greer AB, Patel P, Carrion DM, Paesano N, Kettache RH, et al. Global survey of the roles and attitudes toward social media

platforms amongst urology trainees. Urology. 2021;147:64-7.

20. Dubin JM, Greer AB, Patel P, Carrion DM, Paesano N, Kettache RH, et al. Global survey evaluating drawbacks of social media usage for

practising urologists. BJU International. 2020;126:7-8.

STACY LOEB, MD, MSc, PhD (Hon)

Dr. Loeb is professor of urology and population health at

NYU Grossman School of Medicine. She has more than 350

publications, primarily related to prostate cancer. She is chair

of the American Urological Association Public Media Committee

and hosts the Men¡¯s Health Show on Sirius XM satellite radio.

Department of Urology

Our renowned urologic specialists have pioneered numerous advances in the surgical and pharmacological

treatment of urologic disease.

For questions and/or patient referrals, please contact us by phone or by e-mail.

Faculty

Specialty

Phone Number/Email

James Borin, MD

Kidney stones, Kidney Cancer, Ureteral Stricture, UPJ obstruction, Endourology, Robotic Renal Surgery,

Partial Nephrectomy, Ablation of Renal Tumors, PCNL

646-825-6387

james.borin@

Benjamin Brucker, MD

Female Pelvic Medicine and Reconstructive Surgery, Pelvic Organ Prolapse-Vaginal and Robotic

Surgery, Voiding Dysfunction, Male and Female Incontinence, Benign Prostate Surgery, Neurourology

646-754-2404

benjamin.brucker@

Seth Cohen, MD

Female Sexual Dysfunction, Male Sexual Dysfunction, General Urology, Benign Disease Prostate,

Post-Prostatectomy Incontinence, Erectile Dysfunction, Hypogonadism

646-825-6318

seth.cohen@

Frederick Gulmi, MD*

Robotic and Minimally Invasive Urology, BPH and Prostatic Diseases, Male and Female Voiding

Dysfunction, Kidney Stone Disease, Lasers in Urologic Surgery, and Male Sexual Dysfunction

718-630-8600

frederick.gulmi@

Mohit Gupta, MD?

Urologic Oncology, Open, Laparoscopic, or Robot-Assisted Approaches to Surgery, Surgical

Management of Genitourinary Malignancies including Kidney, Bladder, Prostate, Adrenal, Penile,

and Testis Cancers

646-825-6325

Mohit.Gupta2@

William Huang, MD

Urologic Oncology (Open and Robotic) ¨C for Kidney Cancer (Partial and Complex Radical), Urothelial

Cancers (Bladder and Upper Tract), Prostate and Testicular Cancer

646-744-1503

william.huang@

Grace Hyun, MD

Pediatric Urology including Hydronephrosis, Hypospadias, Varicoceles, Undescended Testicles,

Hernias, Vesicoureteral Reflux, Urinary Obstruction, Kidney Stones, Minimally Invasive Procedures,

Congenital Anomalies

212-263-6420

grace.hyun@

Christopher Kelly, MD

Male and Female Voiding Dysfunction, Neurourology, Incontinence, Pelvic Pain, Benign Prostate Disease

646-825-6322

chris.kelly@

Herbert Lepor, MD

Prostate Cancer: Elevated PSA, 3D MRI/Ultrasound Co-registration Prostate Biopsy, Focal (Ablation)

of Prostate Cancer, Open Radical Retropubic Prostatectomy

646-825-6327

herbert.lepor@

Stacy Loeb, MD, MSc**

Urologic Oncology, Prostate Cancer, Benign Prostatic Disease, Men¡¯s Health, General Urology

718-261-9100

stacy.loeb@

Danil Makarov, MD, MHS***

Benign Prostatic Hyperplasia, Erectile Dysfunction, Urinary Tract Infection, Elevated Prostate-specific

Antigen, Testicular Cancer, Bladder Cancer, Prostate Cancer

718-376-1004

danil.makarov@

Nnenaya Mmonu, MD, MS

Urethral Strictures, Robotic and Open Reconstructive Surgery for Ureteral Obstruction/Stricture, Fistulas,

Bladder Neck Obstruction, Penile Prosthesis, Post Prostatectomy and Radiation Urinary Incontinence

646-754-2419

nnenaya.mmonu@

Bobby Najari, MD

Male Infertility, Vasectomy Reversal, Varicocele, Post-Prostatectomy, Erectile Dysfunction,

Male Sexual Health, Hypogonadism, Oncofertility

646-825-6348

bobby.najari@

Nirit Rosenblum, MD

Female Pelvic Medicine and Reconstructive Surgery, Voiding Dysfunction, Neurourology, Incontinence,

Female Sexual Dysfunction, Pelvic Organ Prolapse and Robotic Surgery

646-825-6311

nirit.rosenblum@

Ellen Shapiro, MD

Pediatric Urology including: Urinary Tract Obstruction (ureteropelvic junction obstruction),

Vesicoureteral Reflux, Hypospadias, Undescended Testis, Hernia, Varicocele, and Complex

Genitourinary Reconstruction.

646-825-6326

ellen.shapiro@

Mark Silva, MD*

Kidney stones, PCNL, Kidney Cancer, UPJ obstruction, Endourology, Robotic Renal Surgery,

Ablation of Renal Tumors

718-630-8600

mark.silva@

Gary D. Steinberg, MD

Muscle-Invasive Bladder Cancer, Non-Invasive Bladder Cancer, Radical Cystectomy,

Urinary Tract Reconstruction After Bladder Removal Surgery

646-825-6327

gary.steinberg@

Lauren Stewart, MD

Female Pelvic Medicine and Reconstructive Surgery, Pelvic Organ Prolapse, Incontinence in Women,

Female Voiding Dysfunction

646-825-6324

lauren.stewart@

Samir Taneja, MD

Urologic Oncology ¨C Prostate Cancer (MRI-Guided Biopsy, Robotic Prostatectomy, Focal Therapy,

Surveillance), Kidney Cancer (Robotic Partial Nephrectomy, Complex Open Surgery), Urothelial Cancers

646-825-6321

samir.taneja@

James Wysock, MD, MS

Urologic Oncology ¨C Prostate Cancer, MRI-Guided Biopsy, Kidney and Prostate Cancer Surgery,

Robotic Urological Cancer Surgery, Prostate Cancer Image-guided Focal Therapy (Ablation, HIFU),

and Testicular Cancer

646-754-2470

james.wysock@

Lee Zhao, MD

Robotic and Open Reconstructive Surgery for Ureteral Obstruction, Fistulas, Urinary Diversions,

Urethral Strictures, Peyronie¡¯s Disease, Penile Prosthesis, and Transgender Surgery

646-754-2419

lee.zhao@

Philip Zhao, MD

Kidney Stone Disease, Upper Tract Urothelial Carcinoma, Ureteral Stricture Disease, and BPH/Benign

Prostate Disease

646-754-2434

philip.zhao@

*at NYU Langone Hospital ¨C Brooklyn ** NYU Langone Ambulatory Care Rego Park



NYU Langone Levit Medical ?222 East 41st street; NYU Langone Ambulatory Care Bay Ridge, and NYU Langone Levit Medical

***

222 East 41st Street New York, NY 10017

U1020

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